Prevalence of complementary and alternative medicine use in Brazil: results of the National Health Survey, 2019

Patricia de Moraes Mello Boccolini, Karine de Lima Sírio Boclin, Islândia Maria Carvalho de Sousa, Cristiano Siqueira Boccolini, Patricia de Moraes Mello Boccolini, Karine de Lima Sírio Boclin, Islândia Maria Carvalho de Sousa, Cristiano Siqueira Boccolini

Abstract

Background: In recent decades, it has been possible to observe an increase in Complementary and Alternative Medicine (CAM) usage globally for both disease prevention and health promotion purposes. we aim to estimate the prevalence of CAM use and analyze associated factors in Brazil.

Methods: Observational study with data from the 2019 National Health Survey that evaluated a sample of Brazilian adults. The outcome was CAM use, such as acupuncture, homeopathy, medicinal plants and herbal medicines, meditation, and yoga in the last 12 months. A logistic regression model with a 99% confidence interval was used to assess factors associated with CAM use.

Results: The prevalence of CAM use in 2019 was 5.2% (CI99% = 4.8-5.6%), the most used modalities: medicinal plants and herbal medicines, with a prevalence of 3.0% (CI99% = 2.7-3.33) followed by: acupuncture 1.4% (CI99% = 1.3-1.6) homeopathy 0.9% (CI99% = 0.7-1.0), meditation 0.7% (CI99% = 0.6-0.8) and yoga 0.4% (CI99% = 0.4-0.5). We observed important geographical differences in CAM use in Brazil, with a higher prevalence in the North Region, 3.7% (CI99% = 2.81-4.75), where herbal medicines were more frequent the in the other regions. After estimating an adjusted model, women, older people, and people with a higher level of education and per capita income were the ones who used all types of CAM the most. The practice of yoga stands out among women 3.6% (CI99% = 2.49-5.28) and among individuals with higher per capita income 7.5% (CI99% = 2.97-18.93); meditation among individuals with higher educational level 13.4% (CI99% = 6.41-28.33) and acupuncture for those who declared regular or poor health 1.9% (CI99% = 1.51-2.39).

Conclusions: We recommend that the Ministry of Health expand CAM access to Unified Health System users and promote health professionals' conscious and guided use for the Brazilian population.

Keywords: Complementary and alternative medicine; Population survey, Brazil; Prevalence.

Conflict of interest statement

The authors have no competing interests as defined by BMC, or other interests that might be perceived to influence the results and/or discussion reported in this paper.

© 2022. The Author(s).

References

    1. World Health Organization (WHO) General guidelines for methodologies on research and evaluation of traditional medicine. Geneva: WHO Organization; 2000.
    1. BRAZIL. Ministry of Health . National Policy for Complementary and Integrative Practices. Ordinance n. 971. Brasília: Brazilian Federal Register, n. 84, section I; 2006. pp. 20–24.
    1. Brazil. Ministry of Health . Health Care Secretariat. Ordinance n. 702, of March 21, 2018. It alters the consolidation ordinance n. 2/GM/MS, of September 28, 2017, to include new practices into the National Policy for Complementary and Integrative Practices. PNPIC Brazilian Federal Register; 2018.
    1. Brazil. Ministry of Health. Agência Nacional de Saúde Suplementar. Resolução Normativa N° 470, de 09 de julho de 2021. Available at: Acessed 28 May 2022.
    1. Sousa IMC, Bezerra AFB, Guimarães MB, Benevides IA, Tesser CD. Traditional, complementary and integrative medicine in the Brazilian public health service: opportunities and limitations. Public health and health services research in traditional, complementary and integrative. Health Care. 2019:197–216. 10.1142/9781786346797_0012.
    1. Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update. Int J Clin Pract. 2012;66(10):924–939. doi: 10.1111/j.1742-1241.2012.02945.x.
    1. Siti ZM, Tahir A, Farah AI, Fazlin SMA, Sondi S, Azman AH, et al. Use of traditional and complementary medicine in Malaysia: a baseline study. Complement Ther Med. 2009;17(5–6):292–299. doi: 10.1016/j.ctim.2009.04.002.
    1. Clarke TC, Barnes PM, Black LI, Stussman BJ, Nahin RL. Use of yoga, meditation, and chiropractors among U.S. adults aged 18 and over. NCHS Data Brief. 2018;(325):1–8. .
    1. Kemppainen LM, Kemppainen TT, Reippainen JA, Salmenniemi ST, Vuolanto PH. Use of complementary and alternative medicine in Europe: health-related and sociodemographic determinants. Scand J Public Health. 2018;46(4):448–455. doi: 10.1177/1403494817733869.
    1. Sistema Integrado de Pesquisas Domiciliares (SIPD). Ministério do Planejamento, Orçamento e Gestão / Instituto Brasileiro de Geografia e Estatística – IBGE. Pesquisa Nacional de Saúde (2019). Available at: . Acessed 28 Oct 2021.
    1. Stopa SR, et al. Pesquisa Nacional de Saúde 2019: histórico, métodos e perspectivas. Epidemiologia e Serviços de Saúde [online]. 2020;29(5):e2020315.
    1. Boccolini CS, Souza Junior PR. Inequities in healthcare utilization: results of the Brazilian National Health Survey, 2013. Int J Equity Health. 2016;15(1):150. doi: 10.1186/s12939-016-0444-3.
    1. Boccolini PMM, Boccolini CS. Prevalence of complementary and alternative medicine (CAM) use in Brazil. BMC Complement Med Ther. 2020;20:51. doi: 10.1186/s12906-020-2842-8.
    1. Viacava F, Porto SM, Carvalho CC, Bellido JG. Desigualdades regionais e sociais em saúde segundo inquéritos domiciliares (Brasil, 1998–2013). Ciência Saúde Coletiva. 2019;24(7). 10.1590/1413-81232018247.15812017.
    1. Camargos MCS, Gonzaga MR, Costa JV, Bomfim WC. Estimativas de expectativa de vida livre de incapacidade funcional para Brasil e Grandes Regiões, 1998 e 2013. Ciência Saúde Coletiva. 2019;24(3):737–747. doi: 10.1590/1413-81232018243.07612017.
    1. Instituto Brasileiro de Geografia e Estatística (IBGE) Os indígenas no Censo Demográfico 2010, primeiras considerações com base no quesito cor ou raça. Rio de Janeiro: IBGE; 2012.
    1. Guimarães MB, Nunes JA, Velloso M, Bezerra A, Sousa MII. As práticas integrativas e complementares no campo da saúde: para uma descolonização dos saberes e práticas. Saúde e Sociedade. 2020;29(1):e190297. doi: 10.1590/S0104-12902020190297.
    1. Conboy L, Patel S, Kaptchuk TJ, Gottlieb B, Eisenberg D, Acevedo-Garcia D. Sociodemographic determinants of the utilization of specific types of complementary and alternative medicine: an analysis based on a nationally representative survey sample. J Altern Complement Med. 2005;11(6):977–994. doi: 10.1089/acm.2005.11.977.
    1. Klein SD, Torchetti L, Frei-Erb M, Wolf U. Usage of complementary medicine in Switzerland: results of the Swiss health survey 2012 and development since 2007. Plos One. 2015;10(10):e0141985. doi: 10.1371/journal.pone.0141985.
    1. Reid R, Steel A, Wardle J, Trubody A, Adams J. Complementary medicine use by the Australian population: a critical mixed studies systematic review of utilisation, perceptions and factors associated with use. BMC Complement Altern Med. 2016;16:176. doi: 10.1186/s12906-016-1143-8.
    1. Malta DC, Bernal RTI, Gomes CS, Cardoso LCM, Lima MG, Barros MBA. Desigualdades na utilização de serviços de saúde por adultos e idosos com e sem doenças crônicas no Brasil. Pesquisa Nacional de Saúde 2019 [preprint] Rev Bras Epidemiol. 2021;24:E210003.supl. doi: 10.1590/1980-549720210003.supl.2.
    1. Kristoffersen AE, Stub T, Salamonsen A, Musial F, Hamberg K. Gender differences in prevalence and associations for use of CAM in a large population study. BMC Complement Altern Med. 2014;3(14):463. doi: 10.1186/1472-6882-14-463.
    1. Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002-2012. Natl Health Stat Report. 2015;10(79):1–16.
    1. Neel K, Goldman R, Nothnagle M. Integrating doulas into hospital births: provider perceptions of doulas and doula care [22C] Obstet Gynecol. 2019;133:37S. doi: 10.1097/01.AOG.0000559443.76117.4a.
    1. Johnson A, Roberts L, Elkins G. Complementary and alternative medicine for menopause. J Evid Based Integr Med. 2019;24:1–14. doi: 10.1177/2515690X19829380.
    1. Brasil, Ministério da Saúde. Relatório de Monitoramento Nacional das Práticas Integrativas e Complementares em Saúde nos Sistemas de Informação em Saúde. 2020 Disponível em: Acessado 20 Sept 21.
    1. Barbosa FES, Guimarães MBL, Santos CR, Benjamin AF, Dalcanale BC. Oferta de Práticas Integrativas e Complementares em Saúde na Estratégia Saúde da Família no Brasil. Cadernos de Saúde Pública. 2020;36(1). 10.1590/0102-311X00208818.
    1. Fjær EL, Landet ER, McNamara CL, Eikemo TA. The use of complementary and alternative medicine (CAM) in Europe. BMC Complement Med Ther. 2020;20(1):108. doi: 10.1186/s12906-020-02903-w.
    1. Nahin RL, Barnes PM, Stussman BJ. Insurance coverage for complementary health approaches among adult users: United States, 2002 and 2012. NCHS Data Brief, no 235. Hyattsville: National Center for Health Statistics; 2016.
    1. Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. Advance data from vital and health statistics; no 343. Hyattsville: National Center for Health Statistics; 2004.
    1. Cramer H. Meditation in Deutschland: Eine national repräsentative Umfrage. Complement Med Res. 2019;26(6):382–389. doi: 10.1159/000499900.
    1. Ding D, Stamatakis E. Yoga practice in England 1997-2008: prevalence, temporal trends, and correlates of participation. BMC Res Notes. 2014;7:172. doi: 10.1186/1756-0500-7-172.
    1. Macinko J, Upchurch DM. Factors associated with the use of meditation, U.S. adults 2017. J Altern Complement Med. 2019;25(9):920–927. doi: 10.1089/acm.2019.0206.
    1. Barros NF, Siegel P, Moura SM, Cavalari TA, Silva LG, Furlanetti MR, Gonçalves AV. Yoga e promoção da saúde. Cien Saude Colet. 2014;19(4):1305–1314. doi: 10.1590/1413-81232014194.01732013.
    1. Kaboli PJ, Doebbling BN, Saag KG, Rosenthal GE. Use of complementary and alternative medicine by older adults with arthritis: a population-based study. Arthritis Rheum. 2001;45:398–403. 10.1002/1529-0131(200108)45:4<398::AID-ART354>;2-I.
    1. Quandt SA, Chen H, Grzywacz JG, Grzywacz JG, Bell RA, Lang W, Arcury TA. Use of complementary and alternative medicine by persons with arthritis: results of the National Health Interview Survey. Arthritis Rheum. 2005;53(5):748–755. doi: 10.1002/art.21443.
    1. Quandt SA, Verhoef MJ, Arcury TA, Lewith GT, Steinsbekk A, Kristoffersen AE, et al. Development of an international questionnaire to measure use of complementary and alternative medicine (ICAM-Q) J Altern Complement Med. 2009;15(4):331–339. doi: 10.1089/acm.2008.0521.
    1. Arcury TA, Bell RA, Snively BM, Smith SL, Skelly AH, Wetmore LK, Quandt SA. J complementary and alternative medicine use as health self-management: rural older adults with diabetes. Gerontol B Psychol Sci Soc Sci. 2006;61(2):S62–S70. doi: 10.1093/geronb/61.2.s62.

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